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Pursuing simplicity in work, home, community, and self

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Mindfulness Through Uncertainty

September 20, 2016 //  by PracticeBalance//  4 Comments

(Old pic of her uncertain face)

We were on a rock climbing trip in Colorado, this time with baby in tow. Five days into the ten day trip, I was so exhausted from consecutive nights of very disrupted sleep that I decided to cut our trip short. Bleary-eyed and unfocused, we headed back home hoping for restorative days in familiar territory.

Unable to initially stay in the present, my thoughts turned to our upcoming European “ideal vacation“: How are we going to deal with this for a month in a foreign country with a night-and-day time difference? Will we even be able to do any climbing while we’re there? And my mind settled on destructive labels: Our baby is a poor sleeper. I’m not doing a good job as a mom.

Then I heard this podcast interviewing Harvard Psychology professor Ellen Langer. In it she said,

“You want to go about life with an air of confidence, but uncertainty.”

It seemed so backward. Why uncertainty? In her view, uncertainty is the key to mindfulness. If you are uncertain, you are open to any outcome, which translates to being completely in the moment. I’m uncertain if my baby will sleep better in the next few weeks, but I’m going to try things to see if I can help her. I am currently testing out a night weaning protocol that I read about, and so far things are looking up. And I’m uncertain if I will climb as much as I’d like to on this upcoming trip. But so what? There are other things to do, and I will be open to exploring them. I’m confident that my baby can become a better sleeper with time, and I’m confident that I’m not a bad mom for having a baby who has sleep issues.

I’ve also been embracing uncertainty over expectations with my work. Upon receiving my nightly email with my assignment for the next day, I used to obsess over the cases, worrying about how they would go. If the patient or the case looked bad “on paper”, I would assume the worst. And yet sometimes, the day would go surprisingly well!

Next time you’re faced with something scary, try dropping the labels and leaning into the uncertainty like I’ve been trying to do. What are you uncertain about today?

Category: UncategorizedTag: mindfulness, parenting, sleep, sleep deprivation, uncertainty, vacation

Self-Care Triage

October 13, 2014 //  by PracticeBalance//  2 Comments

If you’ve ever had the unfortunate experience of a visit to the ER, then you or your injured party were involved in triage. Maybe you sat there waiting to be seen, wondering why others were called back before you. If your reason for showing up in the ER is less serious than another person’s, you will be be seen on a lower priority. This is the concept of triage: the natural prioritization of who and what needs to be addressed first.

With the multiple responsibilities and roles we fill in life during these seemingly shorter and shorter days, it is imperative that we learn how to triage our own self-care. Recently, I was asked by a group of young female medical students to provide some practical tips for self-care. One of them said, “We know we should try to achieve some balance, but no one ever gives us real-life tips on how to do so. I don’t know where to start.” This prompted me to share some concepts I’ve had in my head, organized by priority. Following the theme of simplicity in my Four Realms of Balance (Work, Home, Community, and Self), I chose four basic categories of self-care for my triage: Sleep, Nutrition, Exercise, and Leisure Time.

Sleep. Sleep, which arguably could be lumped into such self-care categories as “rest” or “leisure”, definitely deserves to be a pillar on its own. It is the base of the pyramid of needs, a most important factor… such that all other attempts at self-care will suffer if sleep is inadequately addressed. Check out this Tedx Talk by Dr. Kirk Parsley on America’s Biggest Problem if you don’t believe me. The reality is that many of us will suffer periods of sleep deprivation, either due to work or childcare or other personal reasons, at various points during our lives. And during these challenging times, sleep should be priority number one… above proper nutrition or working out or any other self-care items. In other words, it would be better to eat garbage and not exercise but sleep extra than it would be to have nutrition and workouts dialed without good sleep habits.

The goal should be to get at least 7 hours per night. Of course there will be nights, such as on a call shift, that this will not happen. In that event, every attempt should be made to take a decent nap during the day. And no strenuous exercise should take place! This will merely have a paradoxically negative effect due to increased stress levels in the body. What if your profession involves shift work? This is difficult but can be managed. This blog post by night-shift pharmacist Michelle Tam is one of the best I’ve read about taking care of yourself while regularly working nontraditional hours.

What to do if you must nap at odd hours or have a hard time falling asleep when you should? Make yourself go to bed EARLY. Figure out when you need to wake up and get into bed 8-9 hours before that. Stop looking at the blue screens of TV, phone, or computers at least an hour before you want to fall asleep. If you must look at the computer, install f.lux. Wear a sleep mask. Make your room as dark as possible. Turn up the fan or air conditioner (or turn down the heater).

Nutrition. Without getting into political discussions about food choices or macronutrient ratios, the most broad-based, simple and effective piece of advice I can give here is to eat real food. Basically, 80% of the time you should be eating things that are made at home and/or do not come from a package, restaurant, or vending machine. No matter what your preferred diet (vegetarian, paleo, high protein, low fat, etc.), your food should be as unprocessed as possible. Experiment with some simple meals and go-to snacks that you can bring with you to work. Also have some “emergency” real food on hand for when you get stuck at work late or on-call. Examples of this would be a bag of raw almonds, dried fruit, hardboiled eggs, cans of tuna or salmon, or even an energy bar with minimal ingredients (Larabars are pretty good in that sense).

Exercise. Many people list “exercise” as one of their favorite ways to care for themselves. However, too much or the wrong kind of exercise can actually be detrimental if things like sleep are not optimized. Being in the higher and yet smaller end of the pyramid, exercise should
be modulated based on how well you are doing with your sleep and
nutrition. Just like you can’t fake a good night’s sleep, you can’t “out-train” a poor diet or poor sleep habits.

Now, some people are just not athletic or do not enjoy to exercise. Nevertheless, I maintain that “exercise” is a pillar of self-care for us all, as long as you re-frame it to encompass a broad spectrum of low-level activity to all-out intense sprinting. What is the type of exercise we should all be doing the most? WALKING. Most of us are capable of it, and if we are not, there exists a similar low-level alternative. And all the walking you do during your day can add up to quite a workout! What if it doesn’t because you sit all day at work? Try parking in the remote parking lot, taking short desk-breaks, walking at lunch, taking the stairs, etc. Build your exercise base with walking and fill in the rest with what is appropriate for you. (The topic of exercise deserves its own triage pyramid… a subject for another future post!)

Leisure Time. The rest of “you time” should be made up of things that bring you enjoyment. Not sure what those things are? Well, then you should spend some self-reflection time figuring out what makes you tick! What are your simple pleasures? What kind of personal maintenance activities (baths, massage, creative time, meditation, etc.) do you require to feel good? Take a look back at the Resilient Clinician self-care questionnaire for inspiration and have some go-to ideas.

My triage may seem a bit daunting, but it’s actually very simple. When faced with a choice over how to fill a particular period of time, think of the pyramid. I use it constantly in my own practice of balance; I may have planned to weight train or go bouldering after work, but if I woke up from a bad night’s sleep or work was particularly stressful, I will skip it… or maybe just go for a walk! How about you? How do you prioritize self-care?

Category: UncategorizedTag: exercise, leisure time, nutrition, professional, self, self-care, self-knowledge, self-reflection, sleep, sleep deprivation, work

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PracticeBalance

Dawn L. Baker MD, MS is the founder of PracticeBalance.com. She became interested in the topics of stress management and wellness when she experienced her own health challenges during residency training. Dawn is dedicated to discussing current issues in self-care and simplicity in the four realms of life balance: work, home, community, and self. Her writing has been featured in national syndicates such as KevinMD and Medpage Today, and she is also a regular contributor to the Mothers in Medicine blog. Dawn is a proud wife and mother to one daughter and one whippet dog. In her leisure time, she enjoys traveling, rock climbing, strength and conditioning exercise, attempts at practicing yoga, and long walks with her family.

PB on Instagram

“Next time you write off doing something that seems exclusionary or expensive on the surface, take a closer look and you may be surprised at how much value that expense can provide.”
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Today’s #practicebalance #blogpost has us spending almost $300/mo on a gym membership at @lifetimevegas. The idea came from listening to a podcast with @fatfueledmom, who loves the kids’ activities at their Life Time gym. Does it seem worth the $$? Read (link below or in profile) to decide.
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https://practicebalance.com/2019/02/valueist-staycation-a-gym-membership-or-spa-getaway/
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#newblogpostup #notsponsored #somedocs #valueist #moneymatters #frugaldoc #attendinglife #doctorsofinstagram #toddlermomlife #womeninmedicine #doctormom #vacationspots #staycations #parttimedoctor #fulltimemommy #fitdoc #fitdoctorsofinsta
This is me in Thailand looking for cool shells to make into jewelry. Yes, doctors make jewelry, and yes, doctors wear bikinis. We’re human just like our patients, and the only way we’re going to #beatburnout in medicine is to normalize our human-ness, to thus change the culture and the #hiddencurriculum. Thanks to @drcorriel for starting the #docsbeatburnout challenge. @amyn.cowan, I’m sure you have some things and pics to share about this, so I’m tagging you!
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@tbdslc will be embarrassed by me posting this, but it’s #valentinesday2019. I mean, I got the whole package here: brains & beauty & an awesome father. I’m so lucky he showed up in my freshman engineering class ♥️⚡️😻
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#partnerforlife #thoseabstho #nofilter #nophotoshop #iloveyou #daughterdaddy #toddlermomlife #shello #soluckytohaveyou #vday2019 #bemyvalentine❤️
“Two roads diverged in a wood and I, I took the one less traveled by, and that has made all the difference.” - 🖌Robert Frost
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Life has lots of different paths 🛤 #practicebalance #roadlesstraveled #labyrinth #growingaspen #freerangeparenting #freerangekid #alwayslearn
Are you always trying to reach new heights? How about the height of perfection?
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Today #ontheblog I give my take on self-love and chasing perfection (hint: don’t do it!)... #linkinprofile👆and below:
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https://practicebalance.com/2019/02/be-your-own-valentine/
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#practicebalance #newblogpostalert #selflove #selfimprovement #perfectionism #womenbloggers #womeninmedicine #somedocs #doctormom
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Image credit: stylized AZ sunset by Jim Lowman (my dad)
Getting stronger 💪🏼
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#growingaspen #thatsmygirl #functionalfitness #letthemplay #letthemclimb #outdoorplay #getoutsidemore #climbingtraining #parkplay #toddlermomlife
View of #wasatchmountains sunrise out the airplane window. Headed back to the desert today ❄️🗻➡️☀️🏜
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#parttimedoctor #doctormom #twohomes #homeiswherethe♥️is #blessed🙏🏼
Treacherous conditions today. I had to shovel a foot of snow at 5 am, while it was snowing sideways on me, which then just reaccumulated quickly. Everything is closed... except the hospital of course.
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#thehospitalnevercloses #therewillalwaysbepatients #weareallpatients #attendinglife #residentlife #medstudentlife #doctorlife #womeninmedicine #doctormom #somedocs #anesthesiologist #cantcallinsick #snowsquall #lakeeffect #mountainlife #wintersuckssometimes
Read more from this inspiring woman @frugalphysician on my blog today! #linkinprofile👆or below
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https://practicebalance.com/2019/02/a-balanced-interview-3-the-frugal-physician/
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#practicebalance #newontheblog #womenphysicians #worklifebalance #womenbloggers #doctorblogger #bloginterview #doctormom #womeninmedicine #frugalista #moneymatters #financialfreedom #financialindependence #financialblogger
She’s #mywhy❤️... the reason I #practicebalance, the reason I exercise #selfcare. Even though I had my brush with #burnout and being a patient, she changed the denominator. I’ve simplified my roles in medicine even more. 🌹
Everyone’s balance is different. For me, #resilienceinmedicine means choosing to work part time, have less stuff and less notoriety but more time with her. Thanks to @reflectionsofamillennialdoctor for tagging me! And happy #nationalwomenphysiciansday!
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  1. The content on this site is provided for informational purposes only and does not constitute medical advice.
  2. The opinions and information on this site are my own and are not those of my employer.

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